Enhancing Social Interaction between Preschoolers and Older Adults with Dementia - Report Series # 6

This qualitative intergenerational study, conducted in the spring and summer of 2005, was structured within the parameters of the High/Scope educational approach. High/Scope is guided by active learning which allows children the choice to develop their own learning priorities based on their interests and abilities. Within this model, 5 older adult clients from the Victorian Order of Nurses (VON) Seniors Day Program (Halton Branch) interacted with 5 pre-school children from the Sheridan Child Care Centre. Twelve sessions were conducted over a 6-week time period, and data was collected through both remote (web-casting) and participant observation. Although quantitative data that tracked physical interaction between children and older adults did not show a significant increase in intergenerational interaction, qualitative data indicated greater interaction with frequency of sessions. This study points to a need for further research into specific intergenerational activities and their impact on children, older adults with cognitive impairments and their families

Neonatal hypoxic-ischemic encephalopathy in apparently low risk pregnancies: retrospective analysis of the last five years at the University of Bologna

Objective.To provide recent figures on the occurrence of neonatal hypoxic-ischemic encephalopathy (NHIE) from a Teaching Hospital. Study Design.A retrospective casecontrol study was conducted in a tertiary level university hospital with more than 3000 deliveries annually. Twenty-four cases of NHIE that occurred in apparently low-risk pregnancies were analysed and compared to a group of controls for the most common labor variables. Odds ratios (OR) and 95 confidence intervals (CI) were calculated. Results.Of 15,371 apparently low-risk deliveries, 24 cases of NHIE were observed (0.16), with perinatal death or cerebral palsy occurring in nine of these cases (0.06). The following intra-partum variables were significantly more common in cases than in controls: stained amniotic fluid (OR: 7.50; 95 CI:1.7731.79), maternal fever (none in the control group), abnormal CTG (OR: 253.0; 95 CI: 26.702397), persistent occiput posterior (OR: 15.67; 95 CI: 2.25104.53) and operative delivery (OR: 3.98; 95 CI: 1.3911.33). Conclusion.The incidence of NHIE is considerably low in a Tertiary care Centre

Mode of delivery in the preterm gestation and maternal and neonatal outcome

Objective. To determine if the mode of delivery in preterm gestations is associated with changes in maternal and neonatal outcome. Methods.A retrospective cohort study that included all singleton deliveries occurring after spontaneous onset of labour between 250 and 326 weeks of gestation. Cases of early preterm delivery were identified from clinical records and classified according to the mode of delivery. The following outcomes were derived for each case and compared between caesarean and vaginal deliveries: perinatal death, cranial findings compatible with haemorrhage or white matter disease in the neonate, new-onset of maternal severe anaemia or pyrexia. Results.From 1990 to 2007, 109 cases of spontaneous preterm labour were retrospectively selected, including 50 (45.8) caesarean sections and 59 (54.2) vaginal deliveries. Perinatal death occurred in 10 infants (9.1), whereas among survivors abnormal cerebral findings were detected in 20, including 6 cases with haemorrhage, 12 with white matter findings and 2 with both. At multiple logistic regression, a birthweight lower than 1100g was the only predictor of all adverse outcomes, whereas male sex increased the risk of white matter findings. Caesarean section compared to vaginal delivery conferred a higher risk of maternal complications (23/50 or 46 vs. 6/59 or 10.2; OR: 11.9, CI 95: 4.2333; p<0.0005). Conclusions.In severely premature infants born after spontaneous onset of labour, the risk of adverse perinatal outcome does not seem to depend upon the mode of delivery, whereas the risk of maternal complications is significantly increased after Caesarean section